March 22, 2015

Marijuana Use in Inflammatory Bowel Disease

By Editor

Recent research into the effects of marijuana on specific medical conditions has yielded mixed results. For patients with post-traumatic stress disorder (PTSD), the drug appears to worsen symptoms. In those with inflammatory bowel disease (IBD), however, marijuana might ease discomfort. These findings were presented at the American Academy of Addiction Psychiatry 25th Annual Meeting and Symposium (December 4–7, 2014) in Aventura, Florida.[1],[2]

As marijuana, or cannabis, becomes increasingly available—for both legal recreational and medical use—research into how the drug may impact our health is becoming more important. Whereas we understand the long- and short-term risks of other commonly used substances, such as alcohol and tobacco, marijuana’s health effects are less widely understood, particularly its impact on particular mental and physical disorders.

Two recent studies evaluated the effects of marijuana on two conditions: PTSD and IBD. Whereas marijuana use appeared to worsen symptoms for patients suffering from PTSD, it appeared to provide relief for some individuals with IBD.

Marijuana and Post Traumatic Stress Disorder

Post-traumatic stress disorder is a type of anxiety disorder that can occur after an extreme emotional trauma, often involving the threat of injury or death. Symptoms include flashbacks, upsetting dreams, and recurrent memories of the traumatic event; avoiding thoughts, places, people, and activities associated with the event; negative cognitive and emotional changes; and changes in emotional reactions. People with PTSD tend to be treated with talk therapy (counseling) and medications to ease anxiety and depression. In some states, patients diagnosed with PTSD can qualify for medical marijuana. There is currently little evidence, however, about how marijuana use affects symptoms and severity of PTSD.

To evaluate the effects of marijuana on symptoms and severity of PTSD, researchers from the Yale School of Medicine studied 2,276 veterans with PTSD. They assessed the patients when they were admitted to specialized VA treatment programs for PTSD and again four months after they were discharged. The researchers classified patients according their history of marijuana use as follows:

  • Those who had never used it
  • Those who had used but stopped when they were discharged
  • Those who used at admission and continued after discharge
  • Those who hadn’t used at admission but used after discharge

All groups were monitored for PTSD symptoms, drug and alcohol use, violent behavior, and employment status.

Marijuana appeared to worsen PTSD symptoms as well as violent behavior and drug and alcohol use. Patients who had never used marijuana and those who had stopped had the lowest levels of PTSD symptoms, while those who had started using marijuana after discharge from treatment had the highest levels of violent behavior. As well, patients who started to use marijuana after treatment appeared to have worsened PTSD symptoms and alcohol use.

According to these findings, marijuana is not an effective treatment for patients with PTSD and actually appears to worsen symptoms, even among patients who have received specialized treatment. The researchers therefore concluded that preventing patients from using marijuana or encouraging them to stop might need to be included in treatment for PTSD.

Marijuana and Inflammatory Bowel Disease

As the above findings suggest a negative effect of marijuana use for PTSD patients, other research points to a potential therapeutic benefit among another group of patients—those with IBD.

Inflammatory dowel disease refers to conditions with chronic or recurring immune response and inflammation of the gastrointestinal tract, or digestive tract. Two common examples are ulcerative colitis and Crohn’s disease, which are both characterized by an abnormal response to the body’s immune system. The goal of treatment for IBD is to reduce the inflammation that triggers signs and symptoms. Some research has suggested to marijuana may help protect against inflammation of the digestive tract associated with IBD.

Researchers with the University of Colorado Denver evaluated illegal marijuana use among teenagers with and without IBD. They used questionnaires to learn about how participants used marijuana, how often, for how long, and why.

Of the teenagers who completed the surveys, 65 had IBD and 100 did not. Both groups contained a similar number of girls and boys. Participants in the IBD group tended to be younger and were more likely to be White.

Participants in the IBD group appeared to use marijuana more intensely: 55% used it more than once a week versus 24% of non-IBD participants. The IBD group had also used it more in the past six months: 76 days versus 35 for the non-IBD group. Participants with IBD tended to use marijuana at a younger age—an average age of 16.3 years versus 17 years. Participants with IBD claimed more often that drug use helped them with physical problems.

According to these findings, teenagers with IBD used marijuana at a younger age and more intensely that teenagers without IBD. These teens may be using marijuana to control IBD symptoms, which supports speculation the drug may help control inflammation of the digestive tract. Because of the potential for substance use disorders, however, the researchers suggest screening for substance use among young people with IBD.

References:

[1] Wilkinson ST, Stefanovics E, Rosenheck, RA. Marijuana Use Is Associated with Worse Outcomes in Symptom Severity and Violent Behavior in Patients with PTSD. The American Academy of Addiction Psychiatry 25th Annual Meeting and Symposium. December 4–7, 2014; Aventura, Florida. Paper 5.

[2] Hoffenberg A, Hoffenberg E, Hopfer C, Markson J. Illicit Drug Use and Motivations among Adolescents with and without Inflammatory Bowel Disease. The American Academy of Addiction Psychiatry 25th Annual Meeting and Symposium. December 4–7, 2014; Aventura, Florida. Abstract 38.

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CONDITIONS OF THE GI TRACT